Preventing Calcaneal Spur

Overview


When the body is under stress or constent inflammation it will deposit calcium to our bones. This added 'bone growth' is designed to relieve the added stress/pressure to our connective tissue. In the case of a heel spur, added calcium to the heel bone (calcaneus). It usually forms at the bottom underside of the heel bone where the plantar fascia attaches. This calcium deposit forms over a period of many months. Heel bones can very in shape and size from person to person. An irregular shape heel (calcaneus) can cause the tissue to twist (plantar ligament and Achilles tendon) or a smaller heel bone will put additional stress on tendons and ligaments.


Causes


Heel spurs develop in some people that have a condition called plantar fasciitis, inflammation of the plantar fascia. Heel spurs form when the plantar fascia separates from the calcaneus. An abnormal bone growth, a hook-like spur, forms from calcium deposits that grow at the site of inflammation. Heel spurs are more common in middle-aged adults and people that have had plantar fasciitis for a long time. People with flat feet or high arches are vulnerable to heel spurs. Women who wear high-heeled shoes are more susceptible, as well.





Symptoms


An individual with the lower legs turning inward, a condition called genu valgus or "knock knees," can have a tendency toward excessive pronation. This can lead to a fallen arch and problems with the plantar fascia and heel spurs. Women tend to suffer from this condition more than men. Heel spurs can also result from an abnormally high arch. Other factors leading to heel spurs include a sudden increase in daily activities, an increase in weight, or a thinner cushion on the bottom of the heel due to old age. A significant increase in training intensity or duration may cause inflammation of the plantar fascia. High-heeled shoes, improperly fitted shoes, and shoes that are too flexible in the middle of the arch or bend before the toe joints will cause problems with the plantar fascia and possibly lead to heel spurs.


Diagnosis


Sharp pain localized to the heel may be all a doctor needs to understand in order to diagnose the presence of heel spurs. However, you may also be sent to a radiologist for X-rays to confirm the presence of heel spurs.


Non Surgical Treatment


Rest won?t help you in case of pain from the heel spur. When you get up after sleeping for some time, the pain may get worse. The pain worsens after a period of rest. You will feel pain because the plantar fascia elongates during working which stresses the heel. It is important to see a doctor if you are having consistent pain in you heel. The doctors may advise few or all of the conservative treatments, stretching exercises, shoe recommendations, shoe inserts or orthotic devices, physical therapy, taping or strapping to rest stressed muscles and tendons. There are some over-the-counter medicines available for treatment of heel pain. Acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Aleve) are some such medicines which can help you to get relief from the pain. In case of biomechanical imbalances causing the pain, a functional orthotic device can help you to get relief. Your doctor may also advise a corticosteroid injection for eliminating the inflammation.


Surgical Treatment


More than 90 percent of people get better with nonsurgical treatments. If conservative treatment fails to treat symptoms of heel spurs after a period of 9 to 12 months, surgery may be necessary to relieve pain and restore mobility. Surgical techniques include release of the plantar fascia, removal of a spur. Pre-surgical tests or exams are required to identify optimal candidates, and it's important to observe post-surgical recommendations concerning rest, ice, compression, elevation of the foot, and when to place weight on the operated foot. In some cases, it may be necessary for patients to use bandages, splints, casts, surgical shoes, crutches, or canes after surgery. Possible complications of heel surgery include nerve pain, recurrent heel pain, permanent numbness of the area, infection, and scarring. In addition, with plantar fascia release, there is risk of instability, foot cramps, stress fracture, and tendinitis.


Prevention


To prevent this condition, wearing shoes with proper arches and support is very important. Proper stretching is always a necessity, especially when there is an increase in activities or a change in running technique. It is not recommended to attempt working through the pain, as this can change a mild case of heel spurs and plantar fascitis into a long lasting and painful episode of this condition.